NYC Mayor-Elect Mamdani’s Mental Health Campaign Platform Excerpts

“Too many New Yorkers currently experience mental health issues and, with little access to support, suffer in subway stations and on the streets. The task before the city is to provide real solutions for people in need of mental health support. By making the largest-scale commitment to mental health service provision in New York City history, we’re keeping this city—and its streets and subways—safe. 

The Department of Community Safety (DCS) will oversee unprecedented City investment in mental health services—prioritizing peer-led programs that are proven to create long-term stability and promote recovery. Every New Yorker will be able to access community-based programs and be met with appropriate help and treatment. 

The Department of Community Safety will focus on two categories of mental health solutions, augmenting preventative and ongoing care and crisis intervention, for a cost of $362.8M.

AUGMENTING PREVENTATIVE & ONGOING CARE

To provide people with preventative and ongoing care the DCS will:

• Establish a new Community Mental Health Navigators (CMHNs) program across the city—establishing outposts in every neighborhood with CMHNs who can facilitate connections to care The Mamdani administration will hire and deploy Community Mental Health Navigators who are supervised by licensed mental health professionals. CMHNs will provide an outlet for neighbors, parents, or partners who notice someone struggling but who do not know how to intervene. They will provide free education and support for mental health, offer coping skills training, connection to social services, or referrals if necessary. 
• Create more Peer Clubhousesand support existing ones
  • Peer Clubhouses are peer-led, voluntary rehabilitative programs that provide supportive environments for individuals with serious mental illness to connect with one another, build skills, and participate in activities that run the Clubhouse, fostering recovery and a sense of belonging. Clubhouses have been community “anchors”, successfully addressing mental health issues in New York City for over 75 years 
  • Allow for smaller clubhouses to flourish, reversing Mayor Adams’ Request for Proposal criteria which restricts smaller programs from receiving city funding 
• Expand access to the city’s Youth Mental Health Services, such as Teenspace and Adolescent Skills Centers
• Comprehensively survey existing City programs, including overcoming silos and developing a plan to scale up successful ones (e.g. mobile treatment programs for people with serious mental illness: IMT, ACT, SPACT and FACT)
  • Ensure robust inclusion of specific populations, including the LGBTQ+ community

EXPANDING EVIDENCE-BASED ACUTE CRISIS INTERVENTION

Every New Yorker should have someone to call, someone to respond, and somewhere to go in crisis.

• Overhaul the B-HEARD program
  • B-HEARD—the Behavioral Health Emergency Assistance Response Division— currently deploys health professionals, including EMTs/paramedics from NYC Fire Department and mental health professionals from NYC Health + Hospitals, to respond to 911 mental health calls
  • Move the program into DCS jurisdiction and reform it to be more effective, including a peer counselor on every team; use of trauma-informed care; and a focus on long-term stability—i.e. using diversion centers whenever possible
  • Expand the program so that every neighborhood has a team and the 20 neighborhoods with the greatest need have two to three BHEARD teams, representing a 150 percent increase in funding
• Tripling the size of the Mobile Crisis Team program to institute 24/7 service and improve salaries of team members
• Create an interconnected mobile crisis system
  • Ensure interoperability between 988 and 911 
  • Enable follow-up from Mobile Crisis Teams to BHEARD cases
• Ensure New Yorkers know they can request mental health crisis responders

1. Conduct a massive publicity campaign for 988, including publicizing the ability to request a Mobile Crisis Team and call and text 988 for a range of services such as suicide prevention and crisis counseling, to speak to a peer, or connection to treatment options
2. Study and devise new protocol for emergency dispatch so that New Yorkers can call for crisis response teams directly, in either emergencies or non-emergency situations, and dispatchers are empowered to send crisis teams

• End co-response teams to hand calls off to crisis and outreach teams that are better positioned to address people’s needs
• Implement a peer-based outreach program for our streets and subway system 
• Utilize vacant MTA commercial space for service provision in subway stations
• Increase the number of Transit Ambassadors to assist customers with questions and concerns on their journeys 
• Create new Crisis Residences (formerly ‘Respite Centers’), beginning with opening four in year one
• Institute a Crisis Response Roundtable to create a lasting city commitment to mental health for administrations to come
• Undertake a comprehensive survey of existing City crisis programs to reform, coordinate, and scale up those that are effective
• Sending Mental Health, EMT, and Peer Professionals to Address Crises Works

ADDRESSING SAFETY IN OUR TRANSIT SYSTEM – A CRITICAL PLACE FOR INTERVENTION

The DCS will transform our approach to mental illness and homelessness in our transit system by:

Creating dedicated outreach workers in our subway stations

The mission of these outreach teams will be to give people options that are better and safer than sleeping in the transit system and connected to long-term stability, as well as to intervene in escalating situations. The DCS will overhaul the city’s current system by:

• Stationing teams of three outreach specialists, including peers, mental health professionals and EMTs, to engage with New Yorkers experiencing homelessness and mental health crises. Teams will be in 100 different subway stations, prioritizing those with the highest rates of homelessness and the most reported incidents
  • Peer support on every team is modeled on successful programs like the aforementioned Familiar Faces in Washington
  • As peers have experiences with poverty, substance use, and the criminal legal system, they are best equipped—and evidence supports this—to identify with individuals, build relationships and offer credible support
• Coordinating with, and incorporating insights from, the ​​Street Homeless Advocacy Project
• Ensuring outreach workers can offer credible resources—the key to successful outreach is building relationships that can ultimately offer a continuum of care—psychiatric care, substance abuse treatment, and supportive housing

Also key is paying these workers living wages—currently not the case for our crisis and outreach programs, and most of our human services workers. The Department will ensure all the programs it oversees entail well-paid jobs, with robust training and efficient hiring timelines. Its total cost is $60M.

Transforming vacant commercial units in our stations  

There is abundant vacant space in MTA stations, much of it commercial, that DCS will use to provide medical services to homeless New Yorkers as well as connections to longer term support. By providing access to a safe and reliable location to receive support, we limit incidents of mental distress. Its total cost is $10M.

Investing in highly visible and available Transit Ambassadors

New Yorkers sometimes need information while on the subway platform that can’t always be answered by searching the internet—and sometimes they need immediate assistance for things like a medical emergency. The DCS will oversee an improved Ambassador program at subway stations to assist customers with directions, information regarding line disruptions and accessibility, checking station safety and conditions, and directing anyone in need to the aforedescribed outreach workers or subway service centers. Moreover, the presence of additional workers within stations deters violent or disorderly behavior. 

Transit Ambassador Programs are used in multiple cities across the country, it’s time New York joined in this innovative approach to improving our transit system. Its total cost is $25M.

REDUCING HOMELESSNESS

…The DCS will start by providing greater points of specialist contact to people living on our streets—something most New Yorkers recognize is critical—and, in cases where the person experiencing the mental health crisis is also experiencing homelessness, DCS’s outreach workers will help that person navigate their housing options. Too often, city and state agencies fail to identify and meet the needs of people experiencing mental health crises and homelessness simultaneously. The DCS will fill that gap, and help individuals receive sustained treatment, support, and housing.

The best way to address homelessness is by providing people with lasting homes. While shelters are a necessary form of emergency temporary housing, securing stable housing for someone in crisis has been proven successful at reducing homelessness. The initial stability of a roof over one’s head, and of privacy and dignity, allows people to then address other needs.

Currently, the City neglects a housing-first solution in favor of jailing people. More than 2,500 people held on Rikers Island each year need access to supportive housing. The city spends $1.4 billion to incarcerate them, while it would cost just $108 million to provide them with supportive housing—less than 8 percent of jail expenses. By expanding supportive housing beds, and deploying DCS officers to help direct people experiencing homelessness into them, we can greatly reduce homelessness and save money.

The DCS will function as part of a larger mayoral vision to build affordable housing for all New Yorkers in need, protect tenants from eviction, stand up to negligent landlords, create stable, healthy homes, expand and enforce rental assistance programs and provide more supportive and transitional housing. When the median rent goes up $100, homelessness goes up 9 percent. That means freezing the rent for rent-stabilized units, and reducing the rent burden citywide, is the most powerful tool in the fight against homelessness. 

Investing in outreach and crisis intervention—plus true connection to housing and treatment programs and a continuum of care—for homeless New Yorkers can break cycles of homelessness. This will be one of the Department’s north stars.

GUN VIOLENCE

The DCS will ensure we continue to reduce gun violence using evidence-based crime-reduction strategies that are proven to keep communities safe. The total cost for these investments is $337M.

While gun violence has been decreasing across the city, it remains a crisis—one concentrated geographically and racially. Two-thirds of the city’s shootings happen in the poorest neighborhoods, which are predominantly Black and Latino. Black men are 88 times more likely to be shot, Hispanic men are 23 times more likely to be shot and Asian men are two times more likely to be shot than white men. The DCS will centralize, expand, and invest in community-based violence intervention programs through the Crisis Management System, including gun violence interrupters.